Serial PCR genetic load determination in the surgical management of pneumococcal intracranial sepsis

Bhatia, Robin; Harris, Kathryn; Hartley, John C.; Jeelani, Owase; Harkness, William

doi:10.1007/s00381-012-1715-y

Cited by 1 publication

(1 citation statement)

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“…H owever, this antibiotic pretreatment can lead to false negative microbiological cultures, especially in ascending infections with multiple germs, which have been observed in up to 9 percent of cases [1,6]. In these special situations, in case of persisting septic signs and negative bacterial cultures, alternative microbiological techniques such as PCR can help to detect and control the pathogenic organism [13]. This also underlines the importance for continuing combination antibiotic therapy for several weeks, even after normalisation of infectious parameters.…”

Section: Discussionmentioning

confidence: 99%

Sinogenic Subdural Empyema in a Ten-Year-Old Boy with Sickle Cell Anemia

Nestler¹,

Memia-Zolo²,

Salloum³

et al. 2013

OJMN

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Objective: Sinogenic subdural empyema remains a neurosurgical emergency, even in the antibiotic era. Sickle cell disease is one of the most frequent hereditary diseases, with an incidence of around 4 in 1000 newborns, which necessitates special considerations before a neurosurgical intervention. Case Description: The case of a 10-year-old boy with sickle cell disease type HbSC is reported, who presented with meningitis about ten days after a nasal sinusitis. CT and MRI showed subdural empyema and immediate intravenous antibiotic treatment was started. The patient received partial exchange transfusion. Craniotomy allowed evacuation of empyema and repairment of a frontobasal dural defect. Endoscopic evacuation of the paranasal sinuses was done in the same anesthesia. After initial good recovery, the patient developed right sided paresis with epileptic seizures a few days later. CT scan revealed three distant empyema recurrencies which were evacuated in a second neurosurgical intervention. The child recovered without neurologic deficit, and control MRI examinations three and twelve months after surgery found frontal and parietal dural thickening as sequelae. Conclusion: Urgent neurosurgical interventions in the presence of sickle cell anemia require special anesthesiologic preparations. An immediate, multidisciplinary approach can lead to a good outcome in these life-threatening situations.

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Section: Discussionmentioning

confidence: 99%